ArticleHeliyon2024
Factors involved in the conversion from video-assisted thoracoscopic surgery decortication to open thoracotomy in non-complicated, non-MDR/XDR stage III tuberculous empyema patients: A retrospective intention-to-treat study.
Article in Heliyon, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: This retrospective intention-to-treat study aims to identify risk factors associated with intraoperative conversion from Video-Assisted Thoracoscopic Surgery (VATS) Decortication to open thoracotomy in patients with Stage III Tuberculous Empyema, specifically focusing on non-Multi-Drug Resistant (MDR)/Extensively Drug-Resistant (XDR) cases. Methods: The study included 122 patients with non-MDR/XDR tuberculous empyema who were initially scheduled for VATS decortication. Patients were divided into two groups: the Thoracoscopy group (n = 64), who successfully underwent VATS decortication, and the Conversion group (n = 58), who required intraoperative conversion to open thoracotomy. Complex cases were excluded from the study. The analysis focused solely on factors leading to conversion, rather than overall treatment outcomes. Results: A notable difference was observed in the rate of regular preoperative glucocorticoid utilization between the two cohorts, with the Conversion group exhibiting a lower percentage (46.5 %) in comparison to the Thoracoscopy group (75.0 %). Furthermore, the Thoracoscopy group displayed a significantly reduced frequency of ipsilateral lung abnormalities prior to the surgery (37.5 %), as opposed to that of the Conversion group (65.5 %). Multivariate logistic regression analysis revealed that the regular preoperative glucocorticoid use (odds ratio (OR) = 3.444, 95 % confidence interval (CI): 1.602-7.407) and pre-existing pulmonary lesions (OR = 0.31, 95%CI: 0.150-0.663) were potential influential factors. Conclusion: Inconsistent preoperative glucocorticoid administration and ipsilateral lung lesions were identified as exacerbating factors leading to the complexity of VATS decortication by causing intraoperative pulmonary tissue contusion or hemorrhage, thus hindering the successful completion of VATS decortication and necessitating a conversion to thoracotomy. Awareness of these factors can aid surgeons in making well-informed decisions regarding the preoperative surgical approach.
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